Medical Oncologist, happily married to love of my life, 3 great kids, many dad jokes.
Royal Oak, MI
Joined December 2011
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Matthew Cotant, MD retweeted
Great advance for organ pres in dMMR rectal ca.
AZUR-1 = more nuanced pic than MSK data: 68% w investigator-assessed cCR at 12 mo (47% by central review). But 12/15 undergoing surg for iCR had pCR.
IO works for many, not all (& need better ways to identify residual dz post-IO).
🚨 FDA NEWS |
AZUR 1 Update in #RectalCancer
FDA grants accelerated approval to dostarlimab (Jemperli) for previously untreated stage II/III dMMR/MSI-H locally advanced rectal cancer.First immunotherapy in this setting — may allow some patients to avoid chemo, radiation, and surgery.AZUR-1: 68% cCR12, 76% no evidence of disease ≥1 year, no recurrences in responders (median FU >2 yrs). Nearly ¾ of patients avoided surgery/RT/chemo
@CathyEngMD @BenWestphalen @graokane @NiuSanford @AndresC27622123 @GillSharlene @pashtoonkasi @DrVilmaPBarcia @Erman_Akkus @GIMedOnc @UOzkerim @MarioBalsaMD @p_ciracimd @DraMartinezLago @DaisukeKotani @Aiims1742 @ARosen380 @realbowtiedoc @KoheiShitara @GaiaGriguolo @scocmem
Matthew Cotant, MD retweeted
Making him work from.tbe hospital? He really is the american pope
Matthew Cotant, MD retweeted
Less is more — demonstrated once again — neuropathy once established is a lifelong toxicity for patients to carry and this study demonstrates that we can give our patients back their lives without significant compromise -this study is very consequential as we have moved to the molecularly targeted era in advanced stages - limited induction chemo then let biology dominate the rest of the course @OncBrothers @OncoAlert @MayoCancerCare
This is one of my favorite papers we’ve published , led by our great Mayo resident @WallaceKleinS
“Reduced oxaliplatin exposure in gastrointestinal cancers: A
systematic review and meta-analysis”
We already know from maintenance trials in mCRC that stopping oxaliplatin after 3–4 months is not detrimental for PFS/OS and is associated with less neuropathy.
The question in 2026: what is the evidence in mCRC, the adjuvant setting, and other GI cancers? Is there a situation where oxaliplatin is still needed beyond 3–4 months of induction? In other words — is reduced oxaliplatin exposure associated with worse DFS or PFS across GI cancers?
We did a meta-analysis across GI cancers and settings:
• No statistically significant survival difference overall
• Lower neuropathy and grade ≥3 adverse events
Take-home: don’t keep oxaliplatin going beyond 3–4 months. These findings support limiting exposure to improve the therapeutic index of oxaliplatin-based chemo across GI settings.
sciencedirect.com/science/ar…
@OncoAlert @MayoCancerCare #GIonc @GIcancerDoc @WallaceKleinS
Matthew Cotant, MD retweeted
Check out our recently updates consensus statement regarding first-line treatment for metastatic triple-negative breast cancer (#TNBC).
✍️@rkitadai @FilipaLynce #AnaGarridoCastro @DrTimothyErick #BreastCancer @MBC
physicianresources.dana-farb…
I have a young strong stage four small Cell rectal cancer patient – – extensively pretreated— looking for B7-H3 Ab study in USA Midwest preferred. Please reply back if you have promising study.
Matthew Cotant, MD retweeted
Based off LITESPARK-011: Belzutifan + Lenvatinib is now @FDA ✅ in 2L RCC after IO exposure:
PhIII: Bel + Len vs. Cabo
- mPFS 14.6mos vs. 10.7mos (HR: 0.74)
- mOS 33.7mos vs. 28.6mos (HR: 0.85, p=0.061).
- AEs: 72% vs. 66% w/ Gr ≥ 3
#OncTwitter #gusm @OncUpdates
Matthew Cotant, MD retweeted
FDA 🇺🇸 News: LITESPARK-011 Update in #kidneyCancer
Source: FDA
fda.gov/drugs/resources-info…
On September 24, 2026, the FDA🇺🇸 approved belzutifan plus lenvatinib for adults with advanced renal cell carcinoma containing a clear cell component after PD-1/PD-L1 inhibitor treatment. In the LITESPARK-011 trial, the combination significantly improved progression-free survival and objective response rate versus cabozantinib, while overall survival was not statistically significant.
➡️ Median PFS was 14.6 versus 10.6 months, with response rates of 53% versus 40%. ➡️ Key safety concerns include anemia, hypoxia, cardiac dysfunction, hypertension, and embryo-fetal toxicity.
@DrChoueiri, @tompowles1, @apolo_andrea, @neerajaiims, @montypal, @Silke_Gillessen, @AOmlin, @brian_rini, @PGrivasMDPhD, @TiansterZhang, @AlbigesL, @cdanicas, @amerseburger, @sonpavde, @DrDanielHeng, @declangmurphy, @seanmmcbride, @HHammersMD, @shilpaonc, @DrRanaMcKay, @scserendipity1, @DrYukselUrun, @scocmem, @ravikanesvaran, @AmandaNizamMD, @drenriquegrande, @BraunMDPhD, @EfstathiouEleni, @nataliagandur, @crisbergerot, @realbowtiedoc, @FernandoOnco, @ElisaAgostinett, @to_be_elizabeth, @MarioBalsaMD, @BRicciutiMD, @HHorinouchi, @UOzkerim, @p_ciracimd, @AmandaNizamMD, @scocmem, @DrMirallas
Matthew Cotant, MD retweeted
Daraxonrasib has been added to NCCN guidelines for KRASmt non-small cell lung cancer. Dose at 200 mg instead of 300 . Great speed, many patients that will benefit from this swift inclusion. @RevMedicines
Matthew Cotant, MD retweeted
Big news - Jehovah’s Witnesses can receive PRBC, platelets FFP etc if they want jw.org/en/global-communicati…
Matthew Cotant, MD retweeted
Dr. Chad Rusthoven at #WCLC26 presents results from SWOG S1827, the phase III MAVERICK study exploring the benefit of PCI in pts with SCLC. Historic studies before the era of MRI surveillance showed a decrease in brain metastases with PCI and an improvement in OS but recent ES-SCLC studies called the OS improvement into question. MAVERICK looks at both LS and ES disease - note primary endpoint here is cognitive failure free survival (time to cognitive failure or death) with OS as a key secondary.
Matthew Cotant, MD retweeted
Need to see the details, but…
🔥 Overall survival benefit (1’ end point) for 1L maintenance by adding Tarlatamab to Durvalumab is hugely significant
1L = best place for Tarlatamab. Waiting for relapse & using 2/3L risks never getting it
❗️Issue now is 💵 & reimbursement
JUST IN: DeLLphi-305 study met its primary endpoint of overall survival combining tarlatamab (DLL3 BiTE) with PDL1 inhibitor Durvalumab as maintenance after 1L chemotherapy for extensive-stage small cell lung cancer !
Also RR/PFS significant
Trial led by @DanaFarber @sands_jacob !
Via @PRNews
prnewswire.com/news-releases…
Matthew Cotant, MD retweeted
1/4
NEW ASH ITP GUIDELINES: A REAL CHANGE IN FIRST-LINE THERAPY
For adults with primary ITP requiring treatment, ASH now suggests, conditionally:
Steroids + rituximab
or
Steroids + a TPO agent
rather than steroids alone.
Matthew Cotant, MD retweeted
NCCN 2026 | Breast cancer axilla: who needs what?
• cN0 → SLNB
• >50, postmenopausal, cT1N0/AUS−, HR+/HER2−, G1–2 + BCS/WBRT/ET → consider NO SLNB
• cN0 → SLN− → no further axillary surgery
• 1–2 positive SLNs + appropriate BCS/RT → no ALND
• cN+ → neoadjuvant therapy → ycN0 → SLNB/TAD
• Previously positive node clipped → retrieve the clipped node
• Post-NAC ypN0 → no ALND
• Post-NAC ypN+ → ALND remains standard
Matthew Cotant, MD retweeted
ANDROMEDA FINAL ANALYSIS: D-VCd now shows an OVERALL SURVIVAL benefit in newly diagnosed AL amyloidosis.
After 61.4 months median follow-up, adding daratumumab to VCd translated deeper hematologic responses into better organ outcomes and longer survival.
ANDROMEDA | Phase III | n=388
Daratumumab + bortezomib + cyclophosphamide + dexamethasone vs VCd.
Key results
🔹 Hematologic CR: 59.5% vs 19.2%
OR 6.03, P<0.0001
🔹 Major organ deterioration-PFS:
HR 0.44
95% CI 0.31–0.63, P<0.0001
🔹 Overall survival:
HR 0.62
95% CI 0.42–0.90, P=0.0121
🔹 5-year OS:
76.1% vs 64.7%
🔹 Cardiac and renal responses were consistently 2–3× higher with D-VCd.
Why this matters
This is no longer just a response-rate story.
Earlier ANDROMEDA data established D-VCd as the standard. The final analysis now shows that rapid, deep hematologic control translates into meaningful organ preservation and survival benefit.
Achieving hematologic CR was associated with better survival, while cardiac CR was associated with particularly favorable long-term outcomes.
Limitation
Mayo cardiac stage IIIB patients were excluded, so these results should not be directly extrapolated to the highest-risk cardiac population.
Clinical verdict
✅ PRACTICE CONFIRMING
D-VCd is firmly established as the frontline standard of care for eligible patients with newly diagnosed AL amyloidosis.
📄 Blood. 2026;148:1097-1107
@ASH_hematology @oncoalert
#Amyloidosis #Hematology #Daratumumab
Matthew Cotant, MD retweeted
The long return on discovery science in cancer therapeutics
Sometimes the curves tell the whole story—no need to say much more👇
nature.com/articles/s41568-0…
Matthew Cotant, MD retweeted
Daraxonrasib now @US_FDA ✅ based off RASolute302: Daraxonrasib vs. Chemo in 2L metastatic pancreatic cancer:
- ⬆️ OS: 13.2 vs. 6.7mos (HR: 0.4)
- RAS mutation present in >90% pancreatic adenocarcinoma
- One of the biggest advances/news in 2026 for cancer!
#OncTwitter
Matthew Cotant, MD retweeted
❓☝️
Something caught my attention in the FDA approval of daraxonrasib.
The label includes patients who received ≥1 prior systemic therapy, consistent with RASolute 302, but also patients who are “not candidates for multi-agent systemic therapy.”
Does this effectively extend the approval into the first-line setting for patients considered unfit for multi-agent chemotherapy?
If so, how is “not a candidate for multi-agent systemic therapy” defined in practice?
It seems the FDA label may go beyond the RASolute 302 population—which may be clinically reasonable, but I’m not sure I’m interpreting it correctly.
Matthew Cotant, MD retweeted
Great summary @drenriquegrande
My thoughts: INTerpath-011 may be the most informative of the three. If a personalized neoantigen vaccine adds anything on top of BCG, it tells us the ceiling of BCG has never been about the immune system being insufficiently activated. It has been about the response lacking tumor specificity. That would reframe how we think about intravesical combinations we are currently testing.
@FaltasLab @JoshMeeks @UrogerliMD @PGrivasMDPhD @AmirHorowitz @MaxKates @IBCG_BladderCA
💉 Personalized mRNA cancer vaccines like intismeran autogene (V940/mRNA-4157) can work in genitourinary cancers?
Three ongoing studies are particularly interesting.
🔵 KIDNEY CANCER — INTerpath-004
This randomized, double-blind Phase II study is evaluating adjuvant:
V940 + pembrolizumab vs placebo + pembrolizumab following nephrectomy in patients with RCC at increased risk of recurrence.
The primary endpoint is disease-free survival, with distant metastasis-free survival and overall survival among the secondary endpoints.
If individualized neoantigen vaccination works in RCC, it could therefore tell us something very important about the biology of this platform: its potential may extend beyond simply selecting tumors with very high mutational burden.
🟠 MUSCLE-INVASIVE BLADDER CANCER — INTerpath-005
Here the development strategy is even more ambitious. INTerpath-005 is a Phase I/II program exploring V940 in two different settings.
One cohort evaluates a perioperative strategy combining:
V940 + pembrolizumab + enfortumab vedotin in cisplatin-ineligible patients undergoing radical cystectomy. Another randomized cohort evaluates adjuvant:
V940 + pembrolizumab vs placebo + pembrolizumab in patients with high-risk resected muscle-invasive urothelial carcinoma.
Could we combine three completely different therapeutic principles?
💥 EV → rapidly kills Nectin-4-expressing tumor cells
🔓 Pembrolizumab → releases PD-1-mediated immune inhibition
🎯 V940 → potentially generates an individualized T-cell response against that patient's unique tumor neoantigens
ADC + checkpoint inhibition + personalized vaccination.
Three mechanisms. One objective: eradicate micrometastatic residual disease before it can become clinically visible.
And there is another bladder cancer study that should not be overlooked.
🟡 NON-MUSCLE-INVASIVE BLADDER CANCER — INTerpath-011
This ongoing randomized Phase II study is evaluating: V940 + BCG vs BCG alone in treatment-naïve high-risk NMIBC.
I find this particularly intriguing. BCG has successfully exploited the immune system against bladder cancer for decades. Combining this established local immunotherapy with a systemic, individualized neoantigen-directed immune strategy represents a completely different way of thinking about treatment intensification in early bladder cancer.
Of course, none of these studies is guaranteed to reproduce what we have seen in melanoma.
For someone who has spent much of his career developing new treatments for kidney and bladder cancer, I find the possibility particularly exciting.
Precision oncology has traditionally meant finding the right drug for the right patient.
Personalized mRNA vaccines introduce an even more ambitious concept:
creating a different drug for each individual patient's cancer.
@OncoAlert @_SEOM @GuardConsortium @urotoday @GUOncologyNow @LACOG_group @GEPAC_
Matthew Cotant, MD retweeted
🚨 SAFFRON Phase III is positive
In EGFR-mutated NSCLC with MET-driven resistance after osimertinib, continuing osimertinib + adding savolitinib significantly improved both PFS and OS vs platinum-doublet chemotherapy.
📌 SAFFRON
• N=338
• EGFRm locally advanced/metastatic NSCLC
• MET overexpression/amplification
• Progression after 1L/2L osimertinib
• Osimertinib 80 mg QD + savolitinib 300 mg BID vs platinum-doublet chemotherapy
💡 Why it matters: MET is a major acquired resistance mechanism after EGFR TKIs. This is the first global Phase III trial reporting significant PFS + OS benefit in this setting.
⚠️ No efficacy numbers yet. Full data await presentation.
🩺 Clinical verdict: Potentially practice changing. MET testing after osimertinib progression becomes increasingly important.
@ASCO @oncoalert @AstraZeneca
#LungCancer #NSCLC #EGFR #MET
Matthew Cotant, MD retweeted
🧬 Zolbetuximab hypoalbuminemia
⏱️ Early onset (peak C1-C3)
⚠️ Grade 3: 21%
💧 Edema: 100% | 🍽️ Anorexia: 93% | 🫧 Ascites: 60%
🔄 Usually reversible
✅ Rechallenge often feasible
➖ No clear impact on efficacy
🎯 Check albumin closely first cycles
🔗 doi.org/10.1016/j.esmogo.202…
@OncoAlert
